The evaluation and handling of overlapping in umbrella reviews_Chinese Journal of Evidence-Based Medicine

Authors：

MA Ning ^1,2,3 , PAN Bei ^1,2,3 , DENG Xiyuan ⁴ , WANG Xiaoman ^1,2,3 , LI Dan ² , HE Xin ² , LIU Xiaowei ⁵ , MAO Changxing ⁶ , LIU Yijun ⁷ , NIU Junqiang ^1,3,5 ,  YANG Kehu ^1,2,3

1. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P. R. China;
2. Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
3. Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou 730000, P. R. China;
4. Department of Prenatal Diagnosis Center, Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730000, P. R. China;
5. The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;
6. Huangfumi Hospital of Traditional Chinese Medicine, Pingliang 744499, P. R. China;
7. Wuwei People’s Hospital, Wuwei 733099, P. R. China;

Corresponding author：

YANG Kehu, Email: yangkh-ebm@lzu.edu.cn

Keywords：

Umbrella reviews; Overlap; Corrected covered area (CCA)

DOI：

10.7507/1672-2531.202405025

Video：

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The overlap of literature in umbrella reviews can affect the reliability and accuracy of research conclusions, leading to results with a higher risk of bias. Therefore, it becomes crucial to assess the degree of overlapping and how to handle it. In order to avoid redundant calculations and reduce the risk of bias, researchers need to quantify the degree of literature overlap and adopt corresponding processing strategies. This paper provides a detailed introduction to the calculation methods of overlapping and different strategies for handling overlapping, aiming to provide a reference and guidance for domestic scholars' understanding and application of this method.

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2.	杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价. 中国循证儿科杂志, 2011, 6(1): 54-57.
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4.	Smith V, Devane D, Begley CM, et al. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol, 2011, 11(1): 15.
5.	郑忠礼, 宋旭萍, 赵琳, 等. 中医外治法治疗近视的系统评价再评价. 兰州大学学报(医学版), 2022, 48(5): 79-86.
6.	田金徽, 陈耀龙, 杨克虎, 等. SR/MA研究进展与挑战. 兰州大学学报(医学版), 2016, 42(1): 42-47.
7.	Siontis KC, Hernandez-Boussard T, Ioannidis JP. Overlapping meta-analyses on the same topic: survey of published studies. BMJ, 2013, 347: f4501.
8.	程千吉, 杨秋玉, 田晨, 等. 伞状评价制定方法和步骤. 中国循证医学杂志, 2023, 23(12): 1457-1464.
9.	Ballard M, Montgomery P. Risk of bias in overviews of reviews: a scoping review of methodological guidance and four-item checklist. Res Synth Methods, 2017, 8(1): 92-108.
10.	Kirvalidze M, Abbadi A, Dahlberg L, et al. Estimating pairwise overlap in umbrella reviews: considerations for using the corrected covered area (CCA) index methodology. Res Synth Methods, 2023, 14(5): 764-767.
11.	Pieper D, Antoine SL, Mathes T, et al. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol, 2014, 67(4): 368-375.
12.	廖展琛. 饮食与肾癌发病风险关系的伞形评价. 衡阳: 南华大学, 2022.
13.	Xie Y, Xu J, Zhou D, et al. Micronutrient perspective on COVID-19: umbrella review and reanalysis of meta-analyses. Crit Rev Food Sci Nutr, 2024, 64(19): 6783-6801.
14.	Cui N, Yan X, Zhang Y, et al. Non-pharmacological interventions for minimizing physical restraints use in intensive care units: an umbrella review. Front Med (Lausanne), 2022, 9: 806945.
15.	Shamabadi A, Ahmadzade A, Pirahesh K, et al. Suicidality risk after using cannabis and cannabinoids: an umbrella review. Dialogues Clin Neurosci, 2023, 25(1): 50-63.
16.	García-Muñoz C, González-García P, Casuso-Holgado MJ, et al. Are movement-based mindful exercises (QIGONG, TAI CHI, AND YOGA) beneficial for stroke and Parkinson's disease. A scoping review. Complement Ther Med, 2023, 72: 102912.
17.	Georgoulis V, Haidich AB, Bougioukas KI, et al. Efficacy and safety of carfilzomib for the treatment of multiple myeloma: an overview of systematic reviews. Crit Rev Oncol Hematol, 2022, 180: 103842.
18.	Bougioukas KI, Liakos A, Tsapas A, et al. Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol, 2018, 93: 9-24.
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22.	Bougioukas KI, Diakonidis T, Mavromanoli AC, et al. ccaR: a package for assessing primary study overlap across systematic reviews in overviews. Res Synth Methods, 2023, 14(3): 443-454.
23.	Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
24.	Cooper H, Koenka AC. The overview of reviews: unique challenges and opportunities when research syntheses are the principal elements of new integrative scholarship. Am Psychol, 2012, 67(6): 446-462.
25.	Huang Y, Chen Z, Chen B, et al. Dietary sugar consumption and health: umbrella review. BMJ, 2023, 381: e071609.
26.	Solmi M, De Toffol M, Kim JY, et al. Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies. BMJ, 2023, 382: e072348.
27.	Ferreira GE, Abdel-Shaheed C, Underwood M, et al. Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ, 2023, 380: e072415.
28.	Tang LL, Caudy M, Taxman F. A statistical method for synthesizing meta-analyses. Comput Math Methods Med, 2013, 2013: 732989.
29.	Lunny C, Brennan SE, McDonald S, et al. Toward a comprehensive evidence map of overview of systematic review methods: paper 2-risk of bias assessment; synthesis, presentation and summary of the findings; and assessment of the certainty of the evidence. Syst Rev, 2018, 7(1): 159.
30.	Green J, Howes F, Waters E, et al. Promoting the social and emotional health of primary school-aged children: reviewing the evidence base for school-based interventions. Int J Ment Health Promot, 2005, 7(3): 30-36.
31.	Pollock M, Fernandes RM, Newton AS, et al. A decision tool to help researchers make decisions about including systematic reviews in overviews of reviews of healthcare interventions. Syst Rev, 2019, 8(1): 29.
32.	Gates M, Gates A, Pieper D, et al. Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement. BMJ, 2022, 378: e070849.
33.	Lunny C, Brennan SE, Reid J, et al. Overviews of reviews incompletely report methods for handling overlapping, discordant, and problematic data. J Clin Epidemiol, 2020, 118: 69-85.
34.	孙重阳, 张浩然, 刘晓玉, 等. 伞形综述: 选择与应用最佳综合证据的循证实践. 中国循证医学杂志, 2022, 22(5): 609-614.

1. Becker LA, Oxman AD. Overviews of reviews. 2008.
2. 杨克虎, 刘雅莉, 袁金秋, 等. 发展和完善中的系统评价再评价. 中国循证儿科杂志, 2011, 6(1): 54-57.
3. Aromataris E, Fernandez R, Godfrey CM, et al. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc, 2015, 13(3): 132-140.
4. Smith V, Devane D, Begley CM, et al. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol, 2011, 11(1): 15.
5. 郑忠礼, 宋旭萍, 赵琳, 等. 中医外治法治疗近视的系统评价再评价. 兰州大学学报(医学版), 2022, 48(5): 79-86.
6. 田金徽, 陈耀龙, 杨克虎, 等. SR/MA研究进展与挑战. 兰州大学学报(医学版), 2016, 42(1): 42-47.
7. Siontis KC, Hernandez-Boussard T, Ioannidis JP. Overlapping meta-analyses on the same topic: survey of published studies. BMJ, 2013, 347: f4501.
8. 程千吉, 杨秋玉, 田晨, 等. 伞状评价制定方法和步骤. 中国循证医学杂志, 2023, 23(12): 1457-1464.
9. Ballard M, Montgomery P. Risk of bias in overviews of reviews: a scoping review of methodological guidance and four-item checklist. Res Synth Methods, 2017, 8(1): 92-108.
10. Kirvalidze M, Abbadi A, Dahlberg L, et al. Estimating pairwise overlap in umbrella reviews: considerations for using the corrected covered area (CCA) index methodology. Res Synth Methods, 2023, 14(5): 764-767.
11. Pieper D, Antoine SL, Mathes T, et al. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol, 2014, 67(4): 368-375.
12. 廖展琛. 饮食与肾癌发病风险关系的伞形评价. 衡阳: 南华大学, 2022.
13. Xie Y, Xu J, Zhou D, et al. Micronutrient perspective on COVID-19: umbrella review and reanalysis of meta-analyses. Crit Rev Food Sci Nutr, 2024, 64(19): 6783-6801.
14. Cui N, Yan X, Zhang Y, et al. Non-pharmacological interventions for minimizing physical restraints use in intensive care units: an umbrella review. Front Med (Lausanne), 2022, 9: 806945.
15. Shamabadi A, Ahmadzade A, Pirahesh K, et al. Suicidality risk after using cannabis and cannabinoids: an umbrella review. Dialogues Clin Neurosci, 2023, 25(1): 50-63.
16. García-Muñoz C, González-García P, Casuso-Holgado MJ, et al. Are movement-based mindful exercises (QIGONG, TAI CHI, AND YOGA) beneficial for stroke and Parkinson's disease. A scoping review. Complement Ther Med, 2023, 72: 102912.
17. Georgoulis V, Haidich AB, Bougioukas KI, et al. Efficacy and safety of carfilzomib for the treatment of multiple myeloma: an overview of systematic reviews. Crit Rev Oncol Hematol, 2022, 180: 103842.
18. Bougioukas KI, Liakos A, Tsapas A, et al. Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol, 2018, 93: 9-24.
19. Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions version 6.4 (updated August 2023). Cochrane, 2023.
20. Hennessy EA, Johnson BT. Examining overlap of included studies in meta-reviews: guidance for using the corrected covered area index. Res Synth Methods, 2020, 11(1): 134-145.
21. Pérez-Bracchiglione J, Meza N, Bangdiwala SI, et al. Graphical representation of overlap for overviews: GROOVE tool. Res Synth Methods, 2022, 13(3): 381-388.
22. Bougioukas KI, Diakonidis T, Mavromanoli AC, et al. ccaR: a package for assessing primary study overlap across systematic reviews in overviews. Res Synth Methods, 2023, 14(3): 443-454.
23. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
24. Cooper H, Koenka AC. The overview of reviews: unique challenges and opportunities when research syntheses are the principal elements of new integrative scholarship. Am Psychol, 2012, 67(6): 446-462.
25. Huang Y, Chen Z, Chen B, et al. Dietary sugar consumption and health: umbrella review. BMJ, 2023, 381: e071609.
26. Solmi M, De Toffol M, Kim JY, et al. Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies. BMJ, 2023, 382: e072348.
27. Ferreira GE, Abdel-Shaheed C, Underwood M, et al. Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ, 2023, 380: e072415.
28. Tang LL, Caudy M, Taxman F. A statistical method for synthesizing meta-analyses. Comput Math Methods Med, 2013, 2013: 732989.
29. Lunny C, Brennan SE, McDonald S, et al. Toward a comprehensive evidence map of overview of systematic review methods: paper 2-risk of bias assessment; synthesis, presentation and summary of the findings; and assessment of the certainty of the evidence. Syst Rev, 2018, 7(1): 159.
30. Green J, Howes F, Waters E, et al. Promoting the social and emotional health of primary school-aged children: reviewing the evidence base for school-based interventions. Int J Ment Health Promot, 2005, 7(3): 30-36.
31. Pollock M, Fernandes RM, Newton AS, et al. A decision tool to help researchers make decisions about including systematic reviews in overviews of reviews of healthcare interventions. Syst Rev, 2019, 8(1): 29.
32. Gates M, Gates A, Pieper D, et al. Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement. BMJ, 2022, 378: e070849.
33. Lunny C, Brennan SE, Reid J, et al. Overviews of reviews incompletely report methods for handling overlapping, discordant, and problematic data. J Clin Epidemiol, 2020, 118: 69-85.
34. 孙重阳, 张浩然, 刘晓玉, 等. 伞形综述: 选择与应用最佳综合证据的循证实践. 中国循证医学杂志, 2022, 22(5): 609-614.

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